Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

I'm a doula in Denver and a client
had a question for me about gravity and cord transfusion in the
baby. Their OB told them they had to hold the baby way down
for a while so all the blood went into the baby and "not into
mom." I've never seen this in the births I've attended, if
everything's ok baby immediately goes on mom's chest but this OB is
unwilling to do this or the blood will "go the wrong way."
Now I am of the opinion that you do what is natural and instinctual
(what do mothers do? they reach for their babies!). Dad
really likes to be well educated, read studies, etc. Have you
dug anything up on this?

Years ago, when I was a doula, they used to tell women that they
couldn't have their babies on their chests for exactly the opposite
reason: if the baby was on the woman's chest, it would get too
much blood from the placenta and that would be bad. I
must say that this ob takes ignorance to a new level.
We're all pretty used to obs who don't have their facts right,
but here's one who can't even get the myth
straight.

Jokes at the ob's expense aside, the shut down in blood flow
through the umbilical cord isn't a passive process. The new edition
of Obstetric Myths Versus Research Realities (University
of Michigan Press), co-authored by Amy Romano and me, will
have a chapter on newborn transition. Here is an excerpt from the
manuscript for that chapter:

"At any given
moment, a substantial proportion of fetal blood supply is
circulating through the placenta. After the birth, the baby
recaptures much of that supply. The umbilical arteries, which
deliver deoxygenated blood from the baby to the placenta, constrict
reflexively in response to rising oxygen levels, the drop in
ambient temperature, and other stimuli, while the umbilical vein
remains open for several minutes. This one-way street results in a
net blood flow to the baby after birth that can amount to as much
as 40% of the baby’s blood volume (Mercer 2002). As long as
the placenta remains attached to the uterine wall, this blood is
oxygenated, providing a safety cushion as the newborn transitions
to air breathing. Even after placental detachment, deoxygenated
blood may continue to flow and augment the baby’s blood
volume as the contractions of third stage force additional blood
out of the placenta (Mercer 2002)."

So you see, the
backflow and shut down depends on an elegant feedback mechanism
based on blood oxygenation, not where the baby is relative to the
placenta. The real problem comes with early cord clamping, which
cuts (pun intended) the process short, depriving the baby of a
substantial proportion of its blood supply by trapping it in the
placenta.

-- Henci

All Times America/New_York

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